Agency for Persons with Disabilities Consumer-Directed Care Plus Program 13th Annual Family Caf

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Agency for Persons with Disabilities
Consumer-Directed Care Plus Program13th
Annual Family Café Conference June 3, 2011

• Rhonda Sloan
• Operations Review Specialist/ Training
  Coordinator

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Presentation Overview

• What is the Consumer-Directed Care Plus Program
  (CDC)
• Essential CDC Responsibilities
• Critical CDC Program Updates

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What is the CDC Program 1915(j) State Plan
Amendmentfor Florida Medicaid Waiver Recipients?

• The CDC program empowers recipients of Home and
  Community-Based Medicaid Waiver services with the
  ability to self-direct or independently decide
• Payment for services within an allocated monthly
  budget
• Employment, management, and termination of their
  own directly hired employees, including family
  members
• Permission to use their service budget to pay for
  items that increase personal independence

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Essential CDC ResponsibilitiesParticipant
Responsibility

• With choice comes responsibility The CDC
  participant and his/her CDC representative (if
  one is selected to work with the participant) are
  responsible for learning how to operate the CDC
  program within state and federal rules and
  guidelines and to stay informed of all changes.
• The CDC participant and his/her CDC
  representative are responsible for managing the
  Medicaid funds provided to the participant and
  this responsibility must be taken seriously.

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Essential ResponsibilitiesAPD as DD CDC Fiscal
Agent

• APD serves as the fiscal agent for the DD waiver
  population enrolled in the CDC Program.
• Reviewing and entering consumer purchasing plans
• Processing provider paperwork for state and
  federal tax reporting
• Verification and processing of employee
  timesheets, invoices, and requests for
  reimbursement
• Maintaining a customer service call center

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Available CDC Resources

• Consumer Notebook
• Representative
• Consultant
• APD Area CDC Liaison

• Fiscal/Employer Agent
• Toll-Free Customer Service Line1-866-761-7043
• APD CDC Internet apd.myflorida.com/cdcplus

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APD CDC Program Updates
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Background Screening Changes

• Reminders
• Background Screening Law Change Effective
  August 2010, Florida's background screening laws
  changed to require that all employees of CDC
  participants pass a level 2 background screening
  before they can begin working for the CDC
  participant who is their employer.
• Who This includes everyone providing direct
  care to consumers, all minors and emergency
  back-ups (EBUs) who are listed on a Purchasing
  Plan as natural support.
• Background screening expenses are the
  responsibility of the provider, not the
  participant or representative. Medicaid or CDC
  funds cannot be used for screening or rescreening
  providers.

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Background Screening Changes (continued)

• What about Medicaid providers that you may want
  to hire? If your provider is already a
  Medicaid-enrolled provider who underwent a
  background screening at the time of their
  enrollment into the Medicaid program and has
  remained in good standing, then the provider does
  not have to be screened, but the CDC participant
  may always request a copy of their clearance
  letter.
• Background screenings are valid for five (5)
  years. When time for rescreening, the
  participant/representative must allow enough time
  to process the screening prior to the expiration
  date. Existing providers with Level 1 Background
  Screening must pass a Level 2 Background
  Screening prior to their Level 1 expiration date.
• Sharing copies of clearance letters CDC
  employers can share copies of the clearance
  letter with other CDC employers. The new
  employer must ensure there has not been a break
  in employment of more than 90 days. However, an
  updated local name check and a notarized
  Affidavit of Good Moral Character will be needed.
  

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Background Screening Tips

• Background screening - Make copies of anything
  you send (even fingerprint card)
• Retain documentation, keep everything
• Make sure you have everything for every
  person/vendor you employ
• Track 5-year re-screening and initiate at least 3
  months prior
• FAQ CDC Websiteapd.myflorida.com/background-scre
  ening/docs/cdcfaq.pdf

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CDC Training

• Participant Refresher Training
• Annual Requirement
• Readiness Review
• Certificate
• Readiness Review New participants/representative
  s are required to complete a Readiness Review
  prior to enrolling in the CDC program with at
  least a score of 85. Review is open-book and
  self-directed.
• Consultant (new and refresher) Training
• New consultant ongoing as needed
• Refresher annual requirement

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CDC 1915(j) Quality Assurance

• What recipients, representatives, consultants,
  and directly hired employees need to know about
  quality assurance monitoring
• ? The DD waivers and the 1915(j) programs must
  be monitored for quality assurance as a
  requirement of the federal government for
  Medicaid services. AHCA contracted with Delmarva
  Foundation to conduct the discovery for the
  quality assurance review.
• It includes conducting Person-Centered Reviews
  (PCR) with recipients and Provider Discovery
  Reviews (PDR) with consultants and
  representatives/consumers including documentation
  review of vendors and directly hired employees
  who participate in the CDC program.

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Person-Centered Reviews

• To conduct a Person-Centered Review (PCR),
  recipients are asked to meet with a Delmarva
  reviewer to determine if services are meeting
  needs and/or goals of the recipient, to monitor
  health and safety of the recipient, and to assess
  the program for satisfaction and needed
  improvement.
• The PCR is used to gather information for
  measuring the quality of care, as required by the
  federal government, to monitor service delivery
  and recipient satisfaction of their Medicaid
  program. Average consumer PCR scores are 89.5
  (compared with DD waiver at 83.1).
• The PCR is an easy way for recipients and
  families to receive technical assistance
  regarding rules and regulations for the program.
• The recipient will not lose their place in the
  CDC program based on a single PCR review.
• PCR is an optional review.

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Provider Discovery Reviews

• A Provider Discovery Review (PPR) is conducted
  with the representative and consultant to ensure
  that the recipients care meets the required
  qualifications for the service rendered, based on
  DD handbook requirements for waiver service
  provision and CDC program rules for other goods
  and services. The average consultant score is
  98, and the average rep score is 86.6.
• PDRs will be conducted after a PCR review to
  evaluate provider performance, based on service
  delivery measures and program standards, to
  ensure that the consultant or representative is
• Helping the recipient to meet their expressed
  needs and/or goals determined in PCR review
• Meeting required qualifications for service
  provision
• Ensuring that the health and safety of the
  recipient are being met during service provision.
  
• PDRs are mandatory, if selected, and not
  participating will result in non-compliance.
  Consultant and representative tools are on the
  website.

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CDC APD Quality Assurance Outcome

• The most recent 2010 DD Waiver recipient
  Satisfaction Surveys show
• 95.7 of consumers said their ability to direct
  their own services in the CDC program has
  improved their quality of life.
• 95.7 said they have more control over the
  quality of services
• 97.4 are satisfied with the CDC Program
• 97 of consumers would recommend CDC to others.

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Peer Support Groups

• Networking
• Resources
• Join NOW!

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Contact Information

• APD CDC Customer Service, toll free
• 1-866-761-7043
• Liesl Ramos, Program Administrator
• 1-850-921-3785Agency for Persons with
  Disabilities
• liesl_ramos_at_apd.state.fl.us

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Q A Session